Deliberative and participatory approaches to democracy seek to directly include citizens in decision-making and agenda-setting processes. These methods date back to the very foundations of democracy in Athens, where regular citizens shared the burden of governance and deliberated every major issue. However, thinkers at the time rightly believed that these methods could not function beyond the scale of the city-state, or polis. Representative democracy as an innovation improved on the scalability of collective decision making, but in doing so, sacrificed the (...) extent to which regular citizens could participate in deliberation. Modern technology, including advances in computational power, machine learning algorithms, and data visualization techniques, presents a unique opportunity to scale out deliberative processes. Here we describe Polis, an open source web application capable of collecting and synthesizing feedback from people in a scalable and distributed fashion. Polis has shown itself capable of building shared understanding, disincentivizing counterproductive behavior, and cultivating points of consensus. It has done this in the context of journalistic and academic research, and directly as part of decision-making bodies at local and national levels, directly affecting legislation. These results demonstrate that deliberative processes can be scaled up beyond the constraints of in-person gatherings and small groups. (shrink)

The multi-disciplinary unit Social Responsibility in Action was developed for students with an interest in ethics who were completing undergraduate degrees in Arts, Commerce, Design or Science at an Australian research-intensive university. The academic objectives of this unit were to increase student awareness, knowledge, understanding and critical thinking skills related to various ethical issues. Lecturers from five disciplines collaborated in the design and delivery of SRA, which comprised lectures, tutorials and a research-based project. Anonymous surveys were administered at the start (...) and end of the semester to obtain feedback on student expectations and learning experience, respectively. Data across three student cohorts showed that at the start of semester, 80% of student comments indicated a desire to expand their interest of ethical matters, 59% a desire to gain understanding and knowledge and 59% to gain critical thinking or communication skills. SRA was extremely well received by students, with 98% of respondents indicating that this multi-disciplinary ethics unit had met their expectations. Students also found that the variety of teaching styles, unit content and multi-disciplinary approach stimulated learning. (shrink)

In their article, “Rare Disease, Advocacy and Justice: Intersecting Disparities in Research and Clinical Care,” Halley et al. (2023) use three case examples to describe challenges patients with rar...

The feminist in academe, says Paula Bennett, is like Procne married to Tereus, "inextricably wedded to the sources of her harm." An ethical justification of academic feminism can be found, not in cooperation and affiliation, but in the strategies currently necessary to ensure curricular and cultural diversity. Historically contextualized and strategically politicized, this ethic is founded on the claim that universities are places where we may all learn to know what is other than ourselves.

In writing about `whiteness' we are trying to enact a `way of talking' that draws in part on Aboriginal ideas about how to conduct a conversation or tell a story. We also use Homi Bhabha's ideas of `third space' (an `interruptive, interrogative, and enunciative' space) and hybridity as a related way to think through the problems of essentializing binaries and rigid identities. In Aboriginal cultures in Australia and Canada, rather than adopting the `neutral' or `objective' stance common in the academy, (...) it is customary to introduce oneself to one's audience, providing a context to assist in interpretation and exchange. Without such an introduction, real stories cannot be told and productive conversations cannot happen. We thus begin our conversation with each other and with you by examining our personal relationship to the idea of whiteness in order to reveal some of its complexity in Canada and Australia. `Whiteness' as an abstraction has proved useful in moving the invisible norm to visibility, but we show how an awareness of `whiteness' in the two locations can be recuperated to re-privilege the already privileged. Aboriginal speakers and writers have theorized `whiteness', in many cases from outside the academy, in the process `hybridizing' traditional genres. For many of them, Aboriginality, like whiteness, is a construct that often stands in the way of thinking clearly about where to go next in the fight against racism. (shrink)

In Canada, laws and policies consistently reject the commodification of human organs and tissues, and Canadian practice is consistent with international standards in this regard. Until the Assisted Human Reproduction Act of 2004, gamete donation in Canada was an exception: Canadians could pay and be paid open market rates for gametes for use in in vitro fertilization. As sections of the AHR Act forbidding payment for gametes and permitting only reimbursement of receipted expenses gradually came into effect in 2005, Canada (...) did away with this anomaly. Medical practice and legal prohibitions in assisted human reproduction are now consistent with other areas of medicine where tissues and organs are taken from one person to benefit others: Altruistic donation, rather than selling and buying, will be the norm. (shrink)

The interrogation of Meletus in the Apology at 24c4–28al is not infrequently seen as a typical case of all that is intellectually and artistically dissatisfying in Plato's practice of the genre of philosophical dialogue: not only are we presented with a philosopher who makes some claim to being committed to setting a particularly stringent standard for honesty in argumentation making sophistical arguments, but we are presented also with a cardboard interlocutor who is forced by the hand of Plato to acquiesce (...) to those arguments in a fashion that is completely dissatisfying to the reader. The best anyone seems to do to save Plato from these charges of artistic incompetence and intellectual dishonesty is to appeal to such a level of historical accuracy for the text that the stupidity of Meletus' responses can be attributed to the stupidity of Meletus himself, or to point out features of the political and legal situation that might prevent Meletus from answering the questions by drawing on his true motivation—which is presumably more coherent. Taylor says of this passage:The humour of the situation is that the prosecutor cannot venture to say what he means by either of his charges without betraying the fact that, owing to the ‘amnesty’, the matters complained of are outside of the competency of the court… Hence, when Meletus is pressed to explain what he means, he has to take refuge in puerile nonsense. (shrink)

Some ethicists assert that there is a consensus that maximising medical outcomes takes precedence as a principle of resource allocation in emergency triage of absolutely scarce resources. But the nature of the current severe acute respiratory syndrome-related coronavirus 2 pandemic and the history of debate about balancing equity and efficiency in resource allocation do not support this assertion. I distinguish a number of concerns with justice and balancing considerations that should play a role in critical care triage policy, focusing on (...) discrimination and on fundamental egalitarian and social justice concerns. (shrink)

The interrogation of Meletus in the Apology at 24c4–28al is not infrequently seen as a typical case of all that is intellectually and artistically dissatisfying in Plato's practice of the genre of philosophical dialogue: not only are we presented with a philosopher who makes some claim to being committed to setting a particularly stringent standard for honesty in argumentation making sophistical arguments, but we are presented also with a cardboard interlocutor who is forced by the hand of Plato to acquiesce (...) to those arguments in a fashion that is completely dissatisfying to the reader. The best anyone seems to do to save Plato from these charges of artistic incompetence and intellectual dishonesty is to appeal to such a level of historical accuracy for the text that the stupidity of Meletus' responses can be attributed to the stupidity of Meletus himself, or to point out features of the political and legal situation that might prevent Meletus from answering the questions by drawing on his true motivation—which is presumably more coherent. Taylor says of this passage: The humour of the situation is that the prosecutor cannot venture to say what he means by either of his charges without betraying the fact that, owing to the ‘amnesty’, the matters complained of are outside of the competency of the court… Hence, when Meletus is pressed to explain what he means, he has to take refuge in puerile nonsense. (shrink)

This conceptual review seeks to reframe the view of academic integrity as something to be enforced to an academic skill that needs to be developed. The authors highlight how practices within academia create an environment where feelings of inadequacy thrive, leading to behaviours of unintentional academic misconduct. Importantly, this review includes practical suggestions to help educators and higher education institutions support doctoral students’ academic integrity skills. In particular, the authors highlight the importance of explicit academic integrity instruction, support for the (...) development of academic literacy skills, and changes in supervisory practices that encourage student and supervisor reflexivity. Therefore, this review argues that, through the use of these practical strategies, academia can become a space where a culture of academic integrity can flourish. (shrink)

Are the small and indolent cancers found in abundance in cancer screening normal variations, risk factors, or disease? Naturalists in philosophy of medicine turn to pathophysiological findings to decide such questions objectively. To understand the role of pathophysiological findings in disease definition, we must understand how they mislead in diagnostic reasoning. Participants on all sides of the definition of disease debate attempt to secure objectivity via reductionism. These reductivist routes to objectivity are inconsistent with the Bayesian nature of clinical reasoning; (...) when they appeal to the sciences, they are inconsistent with what philosophy of biology tells us about its natural kinds. Proposals that we narrow the scope of our claims in the disease definition debates are useful, but paradigms can still distort our reasoning in particular cases, even when we are self-conscious about their status. (shrink)

The seriousness of the risk that healthcare workers faced during SARS, and their response of service in the face of this risk, brings to light unrealistic assumptions about duty and risk that informed the debate on duty to care in the early years of HIV/AIDS. Duty to care is not based upon particular virtues of the health professions, but arises from social reflection on what response to an epidemic would be consistent with our values and our needs, recognizing our shared (...) vulnerability to disease and death. Such reflection underwrites a strong duty of care, but one not to be borne solely by the altruism and heroism of individual healthcare workers. (shrink)

PurposeSocial exclusion as a result of gender, race, and class inequality is perhaps one of the most pressing challenges associated with the development of a diverse information technology workforce. Women remain under represented in the IT workforce and college majors that prepare students for IT careers. Research on the under representation of women in IT typically assumes women to be homogeneous in nature, something that blinds the research to variation that exists among women. This paper aims to address these issues.Design/methodology/approachThe (...) paper challenges the assumption of heterogeneity by investigating how the intersection of gender, race, and class identities shape the experiences of Black female IT workers and learners in the USA.FindingsThe results of this meta‐analysis offer new ways of theorizing that provide nuanced understanding of social exclusion and varied emancipatory practices in reaction to shared group exposure to oppression.Originality/valueThis study on the under‐representation of women as IT workers and learners in the USA considers race and class as equally important factors for understanding variation among women. In addition, this paper provides rich insights into the experiences of Black women, a group that is largely absent from the research on gender and IT. (shrink)

The validity of the double effect doctrine is examined in euthanasia and abortion. In these two situations killing is a method of treatment. It is argued that the doctrine cannot apply to the care of the dying. Firstly, doctors are obliged to harm patients in order to do good to them. Secondly, patients should make their own value judgments about being mutilated or killed. Thirdly, there is little intuitive moral difference between direct and indirect killing. Nor can the doctrine apply (...) to abortion. Doctors kill fetuses as a means of treating the mother. They also kill them as an inevitable side effect of other treatment. Drawing a moral distinction between the direct and the indirect killing gives counterintuitive results. It is suggested that pragmatic rules, not ethics, govern practices around euthanasia and cause it to be more restricted than abortion. (shrink)

Some argue that the concept of medical need is inadequate to inform the design of a universal health care system—particularly an institutional rather than a residual system. They argue that the concept contradicts the idea of comprehensiveness; leads to unsustainable expenditures; is too indeterminate for policy; and supports only a prioritarian distribution. I argue that ‘comprehensive’ understood as ‘including the full continuum of care’ and ‘medically necessary’ understood as ‘prioritized by medical criteria’ are not contradictory, and that UHC is a (...) solution to the problem of sustainability, not its cause. Those who criticize ‘medical need’ for indeterminacy are not transparent about the source of their commitment to their standards of determinacy: they promote standards that are higher than is necessary for legitimate policy, ignoring opportunity costs. Furthermore, the indeterminacy of concepts affects all risk-sharing systems and all systems that rely on medical standard of care. I then argue that the concept of need in itself does not imply a minimal sufficientist standard or a prioritarian distribution; neither does the idea of legitimate public policy dictate that public services be minimalist. The policy choice for a system of health care that is comprehensive and offers as good care as can be achieved when delivered on equal terms and conditions for all is a coherent option. (shrink)

BackgroundMoral distress (MD) is an emotional and psychological response to morally challenging dilemmas. Moral distress is experienced frequently by nurses in the intensive care unit (ICU) and can result in emotional anguish, work dissatisfaction, poor patient outcomes, and high levels of nurse turnover. Opportunities to discuss ethically challenging situations may lessen MD and its associated sequela.ObjectiveThe purpose of this project was to develop, implement, and evaluate the impact of nursing ethics huddles on participants’ MD, clinical ethics knowledge, work satisfaction, and (...) patient care among ICU nurses.Sample and SettingThe sample, 32 nurses from three ICU settings in an 800-bed tertiary academic medical center, participated in six nursing ethics huddles over a two-month period.MethodsAlvita K. Nathaniel’s Theory of Moral Reckoning guided development of the nursing ethics huddle process.1 The Moral Distress Thermometer was administered at three data points: baseline level of MD, and pre- and post-huddle to determine changes in the subjects’ level of MD.2 Focused content analysis was used to analyze qualitative responses from questionnaires about the subjects’ perception of the effect of the huddles on work satisfaction and patient care. Knowledge attainment was evaluated via open-ended short-answer questions.ResultsOverall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge. The change in pre- and post-nursing ethics huddles MD scores was statistically significant (p < 0.0001). (shrink)

The series of 'trolley' examples issue a challenge to moral principles based on intentions, since it seems that these give the wrong answers in two important cases: 'Fat Man', where they seem to say that it is permissible to push someone in front of a trolley to save others, and 'Loop', where they seem to say that it is wrong to divert a trolley towards a single person whose body will stop it and save others. I reply, first, that there (...) is a parallel between the wrongful intention to mutilate in 'Transplant', where one person's vital organs are removed to save others' lives, and the intention to assault in Fat Man. Secondly, I defend Frances Kamm's view that in Loop one can divert the trolley towards the one without an intention to kill or assault, since good potential side-effects can be taken into account in deciding what to do, without their becoming intentions. (shrink)

Fair Trade companies have pulled off an astonishing tour de force. Despite their relatively small size and lack of resources, they have managed to achieve considerable commercial success and, in so doing, have put the fair trade issue firmly onto industry agendas. We analyse the critical role played by social capital in this success and demonstrate the importance of values as an exploitable competitive asset. Our research raises some uncomfortable questions about whether fair trade has 'sold out' to the mainstream (...) and whether these companies have any independent future or whether their ultimate success lies in the impact they have had on day-to-day trading behaviour. (shrink)

COVID-19 has truly affected most of the world over the past many months, perhaps more than any other event in recent history. In the wake of this pandemic are patients, family members, and various types of care providers, all of whom share different levels of moral distress. Moral conflict occurs in disputes when individuals or groups have differences over, or are unable to translate to each other, deeply held beliefs, knowledge, and values. Such conflicts can seriously affect healthcare providers and (...) cause distress during disastrous situations such as pandemics when medical and human resources are stretched to the point of exhaustion. In the current pandemic, most hospitals and healthcare institutions in the United States have not allowed visitors to come to the hospitals to see their family or loved ones, even when the patient is dying. The moral conflict and moral distress among care providers when they see their patients dying alone can be unbearable and lead to ongoing grief and sadness. This paper will explore the concepts of moral distress and conflict among hospital staff and how a system-wide provider wellness programme can make a difference in healing and health. (shrink)

This paper was largely written by the General Manager for People and Conservation in South African National Parks (SANParks), with a contribution by an anthropologist studying the post-apartheid transition of Kruger National Park. Our purpose is to engage in an ongoing discussion aimed at equitable best practice and community empowerment in social research and protected areas by bringing together context informed, insider (Masuku Van Damme) and outsider (Meskell) perspectives. It is not intended to offer a conclusive account of people and (...) park dynamics in SANParks. The paper begins with an overview of the establishment of protected areas in South Africa. It then traces conservation philosophies and management principles from 1900 to the present. We then examine the move towards community involvement with conservation areas, outlining the impacts of the World Conservation Strategy and the Brundtland Report. This leads into a discussion of the development of Social Ecology within SANParks, evaluating the successes and failures of consultative efforts with indigenous communities. Lastly, we describe recent moves to include cultural heritage and indigenous knowledge into the programmatics of park management. (shrink)

I discuss some reservations about the exegetical power of the claim that the Tractatus is “anti-metaphysical.” The “resolute” reading has the virtue of fidelity to important and neglected features of the work, both its anti-metaphysical moves and its account of the nature of the activity of philosophy and its status. However, its proponents underestimate the barriers to maintaining a consistent fidelity to these features of the text. The image of a ladder suggests a mere instrumental means to arrive at a (...) place that can itself be characterized independently of our means of arrival; where we arrive via the process of the TLP is the conclusion of an argument, and so cannot be characterized independently of the argument that got us there. In his commitments about the process of logical analysis “within language,” he strives as much as in his statements about the world to return us to our ordinary ways of talking and making sense of what we say to one another. Given the internal relationship Wittgenstein is at pains to emphasize between language, thought, and reality, he could hardly have philosophical commitments about one of these terms (have a residual metaphysics of language) and isolate this from how he thinks about the others. In a discussion of “Senator, you’re no Jack Kennedy” and “Chairman Mao is rare,” I argue that, pace Conant and Diamond’s claims to the contrary, logical categories are being invoked to explain why one cannot mean what one thinks one means in this phrase, and that Wittgenstein is both more anti-metaphysical in his treatment of these logical categories (in contrast with Frege) than the resolute readers consider him to be, and less successful in his treatment of how logical categories rule our judgments of sense and nonsense than they imply he is. Finally, I question the sharp boundary between logic and psychology and the “claustrophobic” feel that is created by a narrow construal of what one can make sense of in another’s words and person that underwrites their account of nonsense via a conflict between the meaning words can contain and our confused desires. Throughout, I discuss relevant passages of the Investigations that resolute readers treat as a re-expression of the themes of the Tractatus, to contrast the “anti-metaphysical” treatment these themes express in the Tractatus with the less dogmatic treatment they receive in the Investigations. (shrink)

Name der Zeitschrift: Klio Jahrgang: 98 Heft: 1 Seiten: 372-375.

Temkin asks how we should distribute resources between the social determinants of health and health care; Sreenivasan argues that if our goal is fair opportunity, funding universal health coverage is the wrong policy. He argues that social equality in health has not improved under UHC and concludes that fair opportunity would be better served by using the resources to address the SDOH instead. His criticism applies more broadly than he claims: it applies to any argument for UHC based on health (...) equity. However, neither his strong causal conclusion nor his stark policy proposal is justified. I review methodological challenges for establishing the relative causal contributions of health care and social policy, concluding that we may never have a robust causal account to support a consequentialist choice. Fortunately, we may not need to answer the allocation question as a dichotomy. Given what Sen calls the multidimensional nature of health equity and the role of UHC in cost containment, UHC may not be a threat to health equity. I also argue against Sreenivasan's claim that the data he discusses should not trouble sufficientists and prioritarians. The worst-off are not simply lagging in improvement; rather, their health status is stagnating or worsening. (shrink)

Verweij and Dawson claim that population health has a distributive dimension; Coggon argues that this presupposes a normative commitment to equity in the very definition of population health, which should, rather, be neutral. I describe possible sources of the distributive view, several of which do not presuppose egalitarian commitments. Two relate to the nature of health as a property of individuals ; two relate to the epistemology and pragmatics of public and population health. A fifth source of the distributive view (...) is a critical stance on the concept of population health; I contrast this with Coggon’s account of the public as a shared political imaginary. None of these views is ‘neutral’: they exhibit several different kinds of normativity and quasi-normativity, but this is not problematic. I argue that the critical stance appropriately distinguishes and relates social justice and public health. (shrink)

Truth-value gaps have received little attention from a foundational perspective, a fact which has rightfully opened up gap theories to charges of vacuousness. This paper develops an account of the foundations of gap-like behavior which has some hope of avoiding such charges. I begin by reviewing and sharpening a powerful argument of Dummett’s to constrain the options that gap theorists have to make sense of their views. I then show that within these strictures, we can give an account of gaps (...) by drawing on elements of a broadly Stalnakerian framework for assertion and using gaps to track an amalgamation of assertoric effects. The discussion reveals that we may need special resources in our theories of assertion to posit gaps, that gaps may be unusable in characterizing the structure of mental states, and that gaps may have heterogeneous linguistic sources that result in equally heterogeneous projective and inferential behavior. (shrink)

Some approaches to the assessment of moral intuitions are discussed. The controlled ethical trial isolates a moral issue from confounding factors and thereby clarifies what a person's intuition actually is. Casuistic reasoning from situations, where intuitions are clear, suggests or modifies principles, which can then help to make decisions in situations where intuitions are unclear. When intuitions are defended by a supporting principle, that principle can be tested by finding extreme cases, in which it is counterintuitive to follow the principle. (...) An approach to the resolution of conflict between valid moral principles, specifically the utilitarian and justice principles, is considered. It is argued that even those who justify intuitions by a priori principles are often obliged to modify or support their principles by resort to the consideration of consequences. (shrink)

Critiques of Knowing explores what happens to science and computing when we think of them as texts. Lynette Hunter elegantly weaves together such vast areas of thought as rhetoric, politics, AI, computing, feminism, science studies, aesthetics and epistemology. This book shows us that what we need is a radical shake-up of approaches to the arts if the critiques of science and computing are to come to any fruition.

_Critiques of Knowing_ explores what happens to science and computing when we think of them as texts. Lynette Hunter elegantly weaves together vast areas of thought: rhetoric, politics, AI, computing, feminism, science studies, aesthetics and epistemology. _Critiques of Knowing_ shows us that what we need is a radical shake-up of approaches to the arts if the critiques of science and computing are to come to any fruition.

Systems of universal health coverage may aspire to provide care based on need and not ability to pay; the complexities of this aspiration call for normative analysis. This special issue arises in the wake of a judicial inquiry into preferential access in the Canadian province of Alberta, the Vertes Commission. I describe this inquiry and set out a taxonomy of forms of differential and preferential access. Papers in this special issue focus on the conceptual specification of health system boundaries and (...) on the normative questions raised by complex models of funding and delivery of care, where patients, providers, and services cross system boundaries. (shrink)